Pregnancy and RA Will rheumatoid arthritis affect my fertility? There is no evidence to show that rheumatoid arthritis affects fertility. Depending on the level of disability, sexual intercourse may be more difficult, but this can be overcome. Arthritis during pregnancy Pregnancy can affect arthritis in many ways. However, a large proportion of women find that the pain and swelling associated with rheumatoid arthritis improves with pregnancy, especially in the early stages. This is due to hormonal changes in the first 14-27 weeks of pregnancy. During the later stages of pregnancy, woman may complain of swelling, backaches and tiredness, but this may be due to the pregnancy and should not necessarily be assumed to be a rheumatoid arthritis ‘flare-up’. Pregnancy and medication Women with rheumatoid arthritis may have concerns about conceiving on medication. If you are planning on trying for a baby, it is important that you discuss this with your doctor, as your medication may need to be adjusted. Some drugs can be continued while you are trying to conceive but others may need to be reviewed. Delivering your baby A woman with RA who feels that she may not have full mobility in her hips should discuss this and any other concerns with their midwife and their rheumatologist prior to birth. At home and breastfeeding Flare-ups of rheumatoid arthritis can occur a few weeks after birth. This is due to hormones returning to normal levels. This period can be a difficult period for the new mother – trying to cope with the pain of rheumatoid arthritis combined with caring for a newborn baby. Talking to a public health nurse about your problems can help. To arrange a visit from a public health nurse, you should ask your GP or talk to someone at your local health centre. There is no reason for you not to breastfeed. Some drugs however can pass through into your breast milk so it is important to ask your doctor which medications are safe to take while breastfeeding. Tips for looking after your newborn baby Carrying, feeding and bathing your new baby and managing your rheumatoid arthritis can be a difficult combination. Below are some helpful tips on how to look after your baby and on how to chose the right equipment: Picking up your baby gradually. Use your forearms instead of your arms to hold a baby’s neck. Find a comfortable position when feeding your baby. Place cushions under your elbows if you are uncomfortable. When choosing baby clothes, avoid fiddly buttons or press studs Buy a good carrying swing and baby support sling for bathing and breastfeeding. Baby carriers – look for simple fastenings, a lightweight frame and padding Cots – choose a cot with adjustable sides or a side that opens completely, and at the right height for you so you do not need to bend too much Prams/pushchairs – these should be easy to fold/unfold, lift and operate, lightweight with simple fastenings and handles that are comfortable to grip For more information on choosing childcare products such as baby carriers and high chairs for parents with disabilities visit the UK consumer website (www.ricability.org.uk). Getting Help ‘Entitlements for people with disabilities’ booklet contains a full range of supports for people with disabilities. A hardcopy is available free from your local Citizens Information Centre, from the Citizens Information Board by emailing email@example.com or phoning 01-6059000). Visit Arthritis Ireland’s website (www.arthritisireland.ie) for further help and information.